Chapter defcribech and commenderh 5 and which | ounces: boylthem till a third part be confum-

many other Phyfitians and Chirurgeons now a | ed. And ‘all thefe are |
daies likewife make ufe of. to be applied blood-warm 3 and they are fo long tobe continued, untill che pucridnets be remo- ved.
After this the Aagy ptiack: Uuguenr, and the Ca- | taplafm but even now mentioned, isto be impof. 'ed; and che reft which were before prefccibed
are {peedily co follow. Where net wich ftanding
But if che Malady wil not yield unto chefe Re- | this 1s to be obferved, that(unle(s in cafe of urgenc medies, then we areto have recourfe unto thofe | neceflicy ) wemuft not have recourfe unro the
that are ftronger, co wit, Caufticks, fuch as chofe Trochifques of Andro, Polyidas,“Mufa, and Pa- fio, which diffolved in Vinegar and Wine may be impofed upon the pare. Many indeed do here commend, and prefer Arfenick before all other Remedies ; but Gulielmus Fabricius doth (and not without good Caufe ) reject and altogether difallow of icin che Cure of aGangrene, as that chat not only hathin ic a Septick and putrefying faculty, anda quality of meltingthe flefh, as 1c were ; bucthat likewife produceth very great and @tievous Symptoms, vehement pain, Dotings, Syncope’s, andthe like, the malignant vapours being communicated unto the principal part. Ir istherefore more fafero make ufe of an actual] Cautery, as chac which bindereth and preventech pucridnets, drieth and corroborateth the part.
This is alfo much commended.
Take Mercury 3 diffolue it in Aqua fortis ; when it diffolved, precipitate it the Oy! of Tartar; afterit is precipitated, wafb it. Or Mercury alone diffolved and mingled wich che Water of che Trinity Flowers; and wollen Cloaths wet in chis Liquor may be impofed on the parc.
The Cruft in what manner foever icbe produc- ed is to be caken away by thofe Medicaments chat have been above declared, inthe firft Parc, and Chap. 13. couching a Carbuncle, WNeitherare we fo wait fo long til Narure thal alcogecher have fe- parated cheCorrupt from ¢be Sound, but the high- eft part of the Cruft is with che edge of a Knife ora Penknife ro be cut.even unco che found part, that fo chere may be a way-made for the Medica- ments unco che deeper parts, andche ceft chac are
actual Caucery, left chat hereby (to wit, by the power and force of the fire ) the extraneous hea e: which is the Caufe of the Gangrene, be augmenr- ed.
Fifthly and Jafély, If the Gan- grene arife from che defect of Ali- ment, and Blood, and Spirits, and chiefly in truch if ic be by reafon of | a Drinefs,andan Atrophy ( neceffa- ty Nurrimenc being denied unto the part) chen meats chat arehocand moift, eafie of Digeftion, and {uch as generate much and good blood, areto
| be given unto che fick Perfon; and oucwardly che | body is likewife co be moiftered with Oyncments | of {weet Oy], or with Oy] of {weec Almonds ; and all chings are carefully to be avoided that ex-~ ficcace and dry the body. Anduntothe parc ic felf chatis already affected with che Gangrene the Aliment 1s by all manner of means co be accracted. And therefore here there is no place Jeft for De- fenfives 5 in regard hac chey fhut and ftop up all paflage of the blood and Spirits unto the part af~ fected. And therefore we are not only to anoyne che parc affe&ted and the other members wich che Juyce of Earch-worms, which is made of che faid’ Eacch-worms firft wafhed in Water, and chenin. Wine,&{o put into a great Veflfel wich good ftore of the Oy] of {weet Almonds & Violets,and mele- ed by agencleand moderate heat over hot Em= bers, and afterwards ftrained ( which is a fpreci- aland foveraign Remedy in the Atrophy, and ex- tenuation ofthe parts )..but che parc affected is cherwich likewile gently co be rnbbed and chated ; unto which 4i{o Cupping-glaffes noc icartfied are tobe applied. Butic wil be moft ficand requi-
A Gangrene by veafon of an Atrophy in tke part.
corrupted. For if we expect uncil che Croft si fice, if there be already prefent a purridnefs, co
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nike pet 4 rt) then. | )peltion, 4, ateto_ | ardly the | yntments nds sand.
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nels OF
nile,
| Chap. 19.
| adminifter thofe things chat doalike both aceract ‘)| and refift pucridnefs; fuch as are, Salc Water,
Of a Gangrene and Sphacelus.
2591
boyled with Watec-Germander, L’quid Pitch, | wich che meal of Lupines, of the biccer Vetch O- robus, Myrch, andche like. But ifthe Gangrene hath already made any progrefs, the part is chen cobe {carified, and che Eaypciack Unguenr, and| chat likewife that is compounded of Pitch, and
be laid thereon. Moreover, If the Gangrene hap-
A Gangrene | en from che interception of che
without any preac danger, as in the Scrotum or Cods; but in other parts che amputation 1s ful of difficulty and peril 5.as in the Feec; Arms, and Hands. Buc after whae manner the faid ampu- tation andthe taking away of that which is cor rupted isto be performed, we wil now acquaint you. Now thismay be done divers waies; fome there be thac having firft applied a Defenfiveup- on che found parr, they chen with many ftraighe
| and oblique Sections {carifie che dead flefh cha¢
liech neec unto the found’; and this they do very deep, even unto thevery bone. And afcerward
from the |) Blood, and the Spits likewile, tail 1 Cwhatfoever che Caufe chen be that (pirits. thus incercep:eth the blood and the
{pirits) itis immediately to be caken away 3 as, if che {aid interception be frora the bin- dirg of che parc, if is forchwith to be loofened 5 and withal chofe Medicamencs chac refift puctid- nefs, as likewilethofe chat difcufs chat that is COLe rupted (fuch as are chofe chat are made of the Meal of Beans, of the bitcec Vetch Orobus, of Lupines, Aloes, Water-Germander, and the like) areto beimpofed. And ifche Gangrene hach al- ready gotten unto any heighch, the place isco be fcarified ; and thofe other things that are requi- red in al Gangrenes, are cobe done. If an aftrin- gent and repelling Medicament be che Caufe, the {aid Medicament being removed, the heat 4s co be
‘recalled by Frictions, Lotions, and Anointings.
And fo we muft alfo proceed in the Gangrene that hath ics original from orber Caufes that intercept theSpirits. For the Cure of the Gangrene 1 felf doth fcarcely at al differ; the difference ly- ing only inthe removal ofthe Caufes. Bucif the Malady be come to thar, thatche Member ts now already alcogecher mortified and dead, and chat ic be fphacelaced, from whatfoever caute it be that the Malady hach its original, there ts then one on- ly way of curingir. For feeing that what 1s al- together dead inthe body cannor poflibly recover life again, and chat it hath now alcogecher the na- ture of a ching that is pret¢rnatural, there is chis
one only Indication, cowit, chat it isto be taken
and amputated fromthe body. Which if (by reafon of the unficnefs of the place) 3¢ cannot conveniently be done, then the cafe 1s wholly def- perace. For fome partsare much more ficly fci- tuaced for amputation chan others 5 as for in- ftance, the fingers, che feet, che hatids, the geni- tals may be cut off with lels dangers But if the Malady bein the Thorax or Cheft, or inthe Bel- Vy, the parts cannot chen bz cut out, and efpeci- ally if chere be many particles of the Member ac Once infected. For ic fomtimes fo fallech our, that the whol Member is no: co be taken away, bac only fome parc thereof. But oftentimes imdeed the whol Member is wholly co be amputated and cut off, to wit, when the putridnefs bath feized upon and corrupted al the paresthereof round a-
bout: which infone may be fpeedily done, and
upon the Wounds they ftrew che pouder of Aries nick and Sublimate, chat fo the mortified part may be feparaced fromthe found.. Buc in this way of exiicpating the corrupt fleth, Arfenick | (as we lately gave younotice) isiufpected ; and therefore in the ftead thereof we are to adminifter other burning Medicamencs, of the afhes of Vine- (prigs and unflaked Lime. The Cruft chat ts al over che part affedted istobe taken away witha Pen- knife; neicher mult weexpect cil ic be fepa- rated of itsown accord. Yet neverthelefs, chac the dead parc may be dried, and be eafily {epara- ced from the found, “Fallopivs applieth chis Spa- radrape :
Take Aloes, Myrrh, Acacia, Gallia Mofcha- ta, Alipta Mofcbata, al the Saunders, Lign A- loes, Cumin, Allum, of each one dram, make a Pouder : Of which,
Take one ounce 5 Ship-pitch, Rofin of thé Pine-tree,Colopbony,of each tro ounces ; Fran- kincenfe, ‘Maftick, Styrax liquid, of each one ounce and balf; Gum Arabick, and Traga- canth, of each balf an ounce: Let them be alk melted ; puta Linen cloth into the Liquor wntib it be throughly foaked in the Medicament. And | afcecwards lec al ocher things be done, as it ufeth co bein ocher Ulcers. There are ochers chat with an actual Caucery burn chac chat 1s corrupted, ¢- lven until there be a pain perceived in the part 5 and al ocher things are afterward to be done accot= ding to att.
But now Fallopins doth advife us Cif much
i dead flefh be robe taken away) not co make ufe of anactual Cautery alone, in regard thac from che faid burning there wil be caufed a moft aba- minableloathfom ftench., Orhers there are that by Section and the Razor ampucace chat that is corrupted; and afterwards co avoid che Hemore rhage, and co dry up and confume the reliquesy they apply likewife an a@tual Cautery, if need res quire. Buc what hath hitherto been {poken tou- ching this way and method of Curing, 1s cobe un
derftood only of that Sphacelus wherein che
whol Member is not corrupted, and when there is no caufe of caking away the Bone likewife.
x
——"
SAS eS Rg ITE a
:
Yc nm
2592 Book V.
enone amen
ee
The cuteing | rupted, and therefore to be amputa-
off the cor) ced, this cannot be effected either joie with an actual Cautery, or a Poten- when tobe 4 tials neither yec with a Razor; buc done. | chere isa neceflicy of cutting off che
| who} entice Member, the Foor, the Hand,&c. But in whac manner chis amputation
ough: co be performed, Authors diffec much in theic opinionsconcerning it. Celfus in his feventh Book, and Chap. 33. perfwadechus co make che Section becwéen che found flefh and the dead; and racher co take away {ome of the found,chanto leave any of the dead flefh remaining, left che Ma- Jady chac is left corrupe chat char istound. Which way of curing moft of our Jate Phyficians difap- prove of, by reafon of thofe dangers that follow the Section inche found parr, co wic, an immo- derate profufion of the blood, and an extraordi- nary gteat pain, and the faincings and {woundings that depend upon chefe. And cheretore chac thefe may be avoided, they advife us co make the